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Table 9-4

Differentiating Grief From Depression

Uncomplicated GriefMajor Depression
Reaction
  • Labile
  • Heightened when thinking of loss
  • Mood consistently low
  • Prolonged, severe symptoms lasting more than 2 months
Behavior
  • Variable, shifts from sharing pain to being alone
  • Variable restriction of pleasure
  • Completely withdrawn or fear of being alone
  • Persistent restriction of pleasure
Sleep patterns
  • Periodic episodes of inability to sleep
  • Wakes early morning
Anger
  • Often expressed
  • Turned inward
Sadness
  • Varying periods
  • Consistently sad
Cognition
  • Preoccupied with loss
  • Self-esteem not as affected
  • Focused on self
  • Feels worthless; has negative self-image
History
  • Generally no history of depression
  • History of depression or other psychiatric illness
Responsiveness
  • Responds to warmth and support
  • Hopelessness
  • Limited response to support
  • Avoids socializing
Loss
  • Recognizable, current
  • Often not related to an identified loss

Source: Adapted from Ferszt, G. G. (2006). How to distinguish between grief and depression? Nursing, 36, 60–61; Brown-Saltzman, K. (2006). Transforming the grief experience. In R. M. Carroll-Johnson, L. M. Gorman, N. J. Bush (Eds.), Psychosocial nursing care along the cancer continuum (2nd ed) (pp. 293–314). Pittsburgh, PA: Oncology Nursing Press.